OBJECTIVETo assess the clinical value of serum complexed prostate-specific antigen(cPSA) in the diagnosis of prostate cancer (PCa).

METHODSSerum samples were obtained from 110 men with untreated benign prostatic hyperplasia (BPH) and 78 men with untreated PCa. The levels of cPSA, total PSA (tPSA) were determined by autoimmunochemistry luminescence method.

RESULTSBoth cPSA and cPSA/tPSA ratio were significantly different between patients with PCa and BPH (P < 0.005), especially, in men with tPSA values between 4.0-10.0 micrograms/L (the diagnostic gray zone). When cPSA/tPSA > or = 0.78 was taken as the cut-off value conjugated with tPSA < or = 10.0 micrograms/L, the sensitivity, specificity, negative predictive value and positive predictive value were as high as 97.8%, 95.8%, 81.9% and 96.5%.

CONCLUSIONSWith the introduction of cPSA and cPSA/tPSA ratio, early diagnosis of PCa by the assessment of tPSA has been made more sensitive and reliable, especially when the tPSA is within the diagnostic gray zone.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; blood ; diagnosis ; Prostatic Neoplasms ; blood ; diagnosis

OBJECTIVETo investigate plasma endothelin-1 (ET-1) level in patients with prostate cancers and its clinical significance.

METHODSPlasma ET-1 level was measured by radioimmunoassay in 31 patients of prostate cancer (23 with non-HRPC, 8 with HRPC) and 26 patients of BPH.

RESULTSCompared with each other of the ET-1 level, there were no significant difference among the BPH group,non-HRPC group and HRPC group. No significant difference was found either between bone metastasis (BM) and non- BM, between high and middling differentiation prostate cancer group, as well as in different PSA level groups (P >0.05). But the ET-1 level in low differentiation prostate cancer was notably lower than those of the high and middle respectively (P < 0.05).

CONCLUSIONTo detect plasma endothelin-1 (ET-1) level is not a useful method to evaluate the development and the prognosis of prostate cancer.

Aged ; Aged, 80 and over ; Endothelin-1 ; blood ; Humans ; Male ; Prognosis ; Prostatic Hyperplasia ; blood ; Prostatic Neoplasms ; blood ; Radioimmunoassay

OBJECTIVETo evaluate two-dimensional gel electrophoresis (2DGE) and mass spectrometry in the studies of the serum proteins expressed in patients with BPH and those with high-grade prostatic intraepithelial neoplasm (HGPIN).

METHODSWe extracted serum proteins from BPH and HGPIN patients by 2DGE and cut the differentially expressed interesting protein spots from the gel. Then we digested the proteins, obtained the peptide mass fingerprint by mass spectrometry and identified the proteins through database retrieval.

RESULTSWe successfully achieved the 2DGE maps of the serum proteins from the BPH and HGPIN patients, obtained 1 421-1 532 protein spots from the 2D map of HGPIN and 1 466-1 778 from that of BPH. Based on peptide mass fingerprinting, 9 of the protein spots were identified. Serum amyloid A was found to be expressed in the HGPIN group, but weakly or not at all in the BPH.

CONCLUSIONProteomics can be applied to the study of the serum proteins in BPH and HGPIN patients. It can afford experimental evidence for the early diagnosis and development HGPIN, promote the search of functional and specific proteins of prostate diseases and shed new light on the network mechanisms of the problems.

Blood Proteins ; analysis ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Male ; Mass Spectrometry ; Prostatic Hyperplasia ; blood ; Prostatic Intraepithelial Neoplasia ; blood ; Prostatic Neoplasms ; blood ; Proteome ; analysis ; Proteomics ; methods

A review of serum prostate-specific antigen (PSA) values from January 1994 to May 1997 and their correlation with the histopathology of prostate specimens was carried out in the Department of Pathology, Port Moresby General Hospital. The study has shown that this biochemical investigation has not been properly used for the maximum benefit of the patient population. Remedial measures are suggested to improve the sensitivity and specificity of PSA in a setting with limited resources.
Aged ; Humans ; Male ; Middle Aged ; Papua New Guinea ; Prostate-Specific Antigen - blood ; Prostatic Hyperplasia - blood

OBJECTIVETo identify the differential expressions of serum cytokines between prostate cancer (PCa) and benign prostatic hyperplasia (BPH), and provide proteomic evidence for the early diagnosis of PCa.

METHODSWe used human cytokine array to determine the profiles of the serum cytokines obtained from 6 PCa and 6 BPH patients with the PSA level within the grey scale of 4 - 10 ng/ml.

RESULTSWe identified 19 differentially expressed cytokines in the PCa patients, 16 obviously up-regulated, including IL-3, IL-6 and IL-16, and 3 markedly down-regulated, which were Fas/TNFRSF6, TRALR-3 and IGFBP-6. Most of them were involved in such cellular bioprocesses as transcription, proliferation, signal transduction, and apoptosis.

CONCLUSIONThe cytokine antibody assay permits simultaneous measurement of multiple markers in a small volume of serum, and can identify a panel of key cytokines related to the malignant biological behavior of cancer cells. And it helps to find the biomarkers for the early diagnosis, efficacy assessment and prognosis of prostate cancer.

Aged ; Humans ; Interleukin-16 ; blood ; Interleukin-3 ; blood ; Interleukin-6 ; blood ; Male ; Middle Aged ; Prostatic Hyperplasia ; blood ; genetics ; metabolism ; Prostatic Neoplasms ; blood ; genetics ; metabolism ; Proteomics

PURPOSE: Several studies have shown that finasteride limits hematuria in patients with benign prostatic hyperplasia(BPH). However, there are few reports addressing dutasteride therapy. We evaluated the effect of dutasteride on intraoperative blood loss and on microvessel density(MVD) in patients with BPH. MATERIALS AND METHODS: We studied 39 patients with BPH who underwent transurethral resection of the prostate(TURP). Group I included 22 patients who received dutasteride 0.5mg daily for 2 weeks preoperatively, and group II included 17 patients who did not. Blood loss was evaluated by comparing preoperative and postoperative hemoglobin. Sections from the prostatic suburothelium and hyperplastic prostate were individually stained for CD 34. MVD was calculated by counting the number of positively stained blood vessels in 5 random high power fields. There were no significant differences between the groups in terms of age, total prostatic volume, resected prostatic weight, or prostate-specific antigen (PSA). RESULTS: The mean MVD in the suburethral portion in dutasteride-treated patients was significantly lower than that seen in untreated patients(14.47 versus 22.19 vessels per high power field, p=0.026). In nodular hyperplasia, there was no significant difference in MVD between the two group(14.72 versus 15.24 vessels per high power field, p=0.801). CONCLUSIONS: Short term pretreatment with dutasteride decreases suburethral prostatic MVD in patients with BPH and may help reduce blood loss during TURP, particularly in huge BPH, which sometimes bleeds excessively during operation.
Azasteroids ; Blood Vessels ; Finasteride ; Hematuria ; Hemoglobins ; Humans ; Hyperplasia ; Microvessels ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Dutasteride

Experience with retropubic prostatectomy in 12 cases of benign prostatic hyperplasia is presented. The operation was technically successful in all cases, even though there were no special instruments available. Operative blood transfusions were given to 2 patients (16.7 per cent). The weight of adenomatous tissue enucleated ranged from 30 to 100 gm., with an average of 46.2 gm. Hospitalization ranged from 9 to 16 days, with a meat of 11 days, The average operating time in this series, including vasectomy, was 79.2 minutes with a range of 55 to 110 minutes. Postoperative complications consisted of one patient with wound infection and patient with severe bleeding due to inadvertent dislodgement of the catheter. The authors believe that there would be broader indication of this approach on Korean patients with benign prostatic hyperplasia.
Blood Transfusion ; Catheters ; Hemorrhage ; Hospitalization ; Humans ; Meat ; Postoperative Complications ; Prostatectomy* ; Prostatic Hyperplasia* ; Vasectomy ; Wound Infection

PURPOSE: To investigate the efficacy and safety of naftopidil for benign prostatic hyperplasia (BPH) patients, mainly focusing on changes in blood pressure (BP). MATERIALS AND METHODS: Of a total of 118 patients, 90 normotensive (NT) and 28 hypertensive (HT) patients were randomly assigned to be treated with naftopidil 50 mg or 75 mg for 12 weeks, once-daily. Safety and efficacy were assessed by analyzing changes from baseline in systolic/diastolic BP and total International Prostate Symptom Score (IPSS) at 4 and 12 weeks. Adverse events (AEs), obstructive/irritative subscores, quality of life (QoL) score, maximum urinary flow rate (Qmax), and benefit, satisfaction with treatment, and willingness to continue treatment (BSW) questionnaire were also analyzed. RESULTS: Naftopidil treatment decreased mean systolic BP by 18.7 mm Hg for the HT 50 mg group (p<0.001) and by 18.3 mm Hg for the HT 75 mg group (p<0.001) and mean diastolic BP by 17.5 mm Hg for the HT 50 mg group (p<0.001) and by 14.7 mm Hg for the HT 75 mg group (p=0.022). In the NT groups (both naftopidil 50 mg and 75 mg), naftopidil elicited no significant changes in BP from baseline values. After 12 weeks, naftopidil 50 and 75 mg groups showed significant improvements in IPSS scores (total, obstructive/irritative subscores, QoL score) and Qmax from baseline. AEs were reported in 7.8% (50 mg group) and 2.9% (75 mg group) of patients. In both the 50 mg and 75 mg groups, >86% of all patients agreed to continue their current medications. CONCLUSION: Our results suggest that naftopidil treatment in BPH patients with hypertension allows for optimal management of BP within the normal range.
Blood Pressure ; Humans ; Hypertension* ; Prospective Studies* ; Prostate ; Prostatic Hyperplasia* ; Quality of Life ; Reference Values ; Treatment Outcome*

Purpose: This study aimed at evaluating the expected additive blood pressure (BP) lowering effect of vardenafil when administered in the background of chronic alpha1-blocker therapy. Materials and Methods: Patients (n=90) with symptomatic benign prostatic hypertrophy (BPH) and erectile dysfunction (ED) took vardenafil 20mg in the morning following repeated doxazosin gastrointestinal therapeutic system (GITS) 4mg (n=60) or tamsulosin 0.2mg (n=30) HS a day for 30 days. The standing and sitting BP at baseline, before taking the vardenafil and 30 minutes and 1 hour post vardenafil were measured 3 consecutive times. The data were analyzed by Student's t-test (paired), repeated measures of two-way ANOVA, chi-square tests and Pearson correlation analysis. Results: Doxazosin produced a significant reduction in systolic/diastolic BP ( 12.3/ 6.7mmHg), but tamsulosin did not. In the doxazosin group, the average reductions in BP from baseline ( 24.7/ 15.8mmHg) were significantly higher than that for the tamsulosin group ( 14.6/ 7.5mmHg). However, the average BP change was not different in both group ( 12.4/ 9.1mmHg in the doxazosin group and 11.3/ 6.4mmHg in the tamsulosin group) following a single dose of 20mg vardenafil. The higher the BP was at baseline, the more the reduction in BP was in both the doxazosin and tamsulosin groups. Two patients of tamsulosin showed a sitting systolic BP <85mmHg, but they didn't experience dizziness. Conclusions: We recommend starting Vardenafil treatment in the background of chronic aalpha1 blocker therapy, including tamsulosin, with a low dose and to increase the dose by monitoring the BP, particularly for the patients with hypertension.
Blood Pressure* ; Dizziness ; Doxazosin* ; Drug Interactions* ; Erectile Dysfunction* ; Humans ; Hypertension ; Male ; Prostatic Hyperplasia* ; Vardenafil Dihydrochloride

OBJECTIVETo establish a prostatic hyperplasia model with Beagle canines.

METHODSTwenty-four two-year-old male Beagle canines were divided into treatment and control groups at random and were administrated testosterone propionate (TP) through intramuscular injection two months after castration. Three treatment groups were given 0.8, 2.5 and 7.5 mg/kg TP respectively, and the control was given the same volume of vehicle. Two months later, half of the animals were killed and the serum and prostate were prepared. After the wet weight and volume of prostate were measured, the dihydrotestosterone (DHT) level of serum and prostate were detected with DHT radioimmunoassay (RIA) kit, and paraffine section from canine prostate was stained by the HE methods. Pictures were taken by digital camera under microscope, and all the pictures were analyzed by computer for epithelial cell height and acinar luminal area of prostate with micro image analysis software. The canine prostate volume was measured with ultrasonic diagnosis instrument before castration, at two months after castration and at two months after being given TP.

RESULTSThe ultrasonic results showed that the prostate volumes of all the canines were smaller at two months after castration than before castration (P < 0.05), and after having been administrated TP for two months, and the prostate volumes of all treatment groups were larger than those of the control group (P < 0.01). The wet weight of the prostate of the treatment group was higher than that of the control group (P < 0.05), and both had dose-dependent relationship. The DHT level of serum and prostate of the canines became higher with the increase of TP dose. The results of micro image analysis showed that the acinar luminal area of prostate was enlarged, and the epithelial cell height increased with larger dose of TP.

CONCLUSIONSIt is practicable to establish prostatic hyperplasia model in Beagle canines after two months of TP administration.

Animals ; Dihydrotestosterone ; blood ; Disease Models, Animal ; Dogs ; Male ; Orchiectomy ; Prostatic Hyperplasia ; etiology ; Testosterone Propionate ; pharmacology